Local prevalence of extended-spectrum beta-lactamase (ESBL) producing <i>Enterobacteriaceae</i> intestinal carriers at admission and co-expression of ESBL and OXA-48 carbapenemase in <i>Klebsiella pneumoniae</i>: a prevalence survey in a Spanish University Hospital.

Abstract

To assess the prevalence of extended-spectrum beta-lactamase (ESBL)-producing <i>Enterobacteriaceae</i> (ESBL-E) faecal carriers at admission in a University Hospital in Spain. Prevalence survey. Pneumology, gastroenterology, urology and neurosurgery units at a university tertiary hospital in Madrid (Spain). A total of 10 643 patients aged 18 and older admitted from March 2014 to April 2016 with a rectal swab taken at admission or as soon as possible within the first 48 hours. Prevalence of ESBL-E faecal carriers and prevalence of ESBL-E infections at admission. The prevalance of ESBL-E carriers at admission was 7.69% (CI 95% 7.18 to 8.19). Most of the isolates were <i>Escherichia coli</i> (77.51%), followed by <i>Klebsiella pneumoniae</i> (20.71%). Eighty-eight (10.41%) of ESBL-E were simultaneous ESBL and carbapenemase (CP) producers, 1.83% in the case of <i>E. coli</i> and 42.86% among <i>K. pneumoniae</i> isolates. Of the ESBL typed, 52.15% belonged to the cefotaximases (CTX-M-15) type and 91.38% of the CP were oxacillinase (OXA-48) type. Only 0.43% patients presented an active infection by ESBL-E at admission. The prevalence found in our study is very similar to that found in literature. However, we found a high percentage of simultaneous ESBL and CP producers, particularly in <i>K. pneumoniae</i>. Despite the high prevalence of colonised patients, the ESBL-infection rate at admission was very low.